What should you know about infant acid reflux?

A baby may bring up small amounts of milk, swallow repeatedly, hiccup, arch during feeds or become unsettled when laid down. Some babies have reflux without obvious spit-up. Cough, abdominal pain or difficulty sleeping can have many causes, so these symptoms alone do not establish reflux.

Reflux can be simple feeding-related regurgitation or a more troublesome pattern affecting comfort, feeding or growth. A clinician may ask about feed volumes, wet nappies, vomiting colour, stool changes and weight gain before recommending treatment.

Keep feeds calm and allow pauses for burping. Hold your baby upright while awake after feeding, following safe handling advice, and avoid pressing the abdomen. Do not thicken feeds, change formula or use medicines unless a clinician recommends a specific product and dose. For sleep, place your baby flat on their back on a firm, clear sleep surface; do not use wedges or sleep positioners.

Keep a brief record of feeds, spit-up, crying, sleep and wet nappies. This can help a GP or paediatric clinician distinguish reflux from feeding difficulty, allergy or another problem.

Seek urgent medical help for green or bloody vomit, forceful repeated vomiting, breathing difficulty, a swollen or very painful abdomen, unusual limpness, dehydration or a baby who is difficult to wake. Arrange a prompt review if feeding is persistently difficult, wet nappies decrease, weight gain is a concern or symptoms are repeatedly disturbing sleep.

Ask whether the pattern fits reflux, how to adjust feeding safely, whether an allergy or another condition should be considered, and how progress will be monitored. Ask for clear instructions before giving any over-the-counter remedy.